Glandular-cystic hyperplasia of the endometrium

Uterus with numerous cysts (yellow arrow) and expansion of individual uterine sections due to accumulation of secretion (white arrows). 1 ovarian pocket, 2 mesometrium.

The same uterus opens in the area of ​​the uterine swellings with numerous cysts (arrows) of the endometrium.

The glandular-cystic hyperplasia of the endometrium is a pathological thickening ( hyperplasia ) of the endometrium (the mucous membrane of the uterus ), which due to the special features in the sexual cycle , especially in domestic dogs occurs. It can be regarded as a preliminary stage of a real endometritis or pyometra (uterine suppuration) and is therefore assigned to the endometritis-pyometra complex . In caviomorpha and lagomorphs a glandular-cystic hyperplasia of the endometrium is also quite common here but rarely pyometra, but rather a developed Hämometra .

Causes and origins

Glandular-cystic hyperplasia of the endometrium occurs mainly in older bitches (> 6 years). It is triggered by a hormonal disruption in the sexual cycle. Here, the relationship between the two sex hormones progesterone and the estrogen estradiol is disturbed in such a way that a prolonged estrogen phase overlaps the progesterone phase. The cause of the prolonged estrogen phase is either delayed rupture of the follicle , ovarian cysts or hormone treatments to suppress heat or to prevent nidation . In dogs, the occurrence of this disorder is favored by the very long metestrus ("after-heat", lasts two to three months).

Due to the overlapping of the two hormone effects, on the one hand, estrogens stimulate the proliferation , blood flow and edematization of the uterine lining; on the other hand, progesterone promotes the secretion of the glands of the mucous membrane. As a result, cysts emerge from the glands ( glandules ) . The pathological changes in the endometrium increase cumulatively from heat to heat.

The changes in the uterine lining can be divided into four stages:

• Type 1: uncomplicated glandular-cystic hyperplasia
• Type 2: Glandular-cystic hyperplasia with infiltration of plasma cells
• Type 3: Glandular-cystic hyperplasia with acute endometritis
• Type 4: Glandular-cystic hyperplasia with chronic endometritis

Symptoms

The disease is largely symptom-free and resembles a chronic inflammation of the uterine lining. There may be a discharge from the vagina and, due to the prolonged estrogen effect, a lasting attraction for males. In guinea pigs, the disease manifests itself in the presence of blood in the urine.

Pathologically and anatomically, the uterine horns are thickened (1 to 3 cm) and there are cysts 1 to 7 mm in size.

The most common complication is the development of a pyometra . Since high estrogen levels can also damage the bone marrow , anemia , thrombocytopenia, or leukopenia can occur.

therapy

Treatment of the disease is difficult. In a study by Corrada, in 3 out of 7 cases with cabergoline, freedom from symptoms was achieved within 7 days. For bitches not used for breeding, an ovariohysterectomy is the method of choice.

Individual evidence

1. ↑ ^{a b} Konrad Blendinger: The bitch's pyometra - an overview . In: small animal concrete volume 19, 2016, issue 3, pp. 24–33, doi : 10.1055 / s-0041-110496 .
2. ↑ C. Dow: The cystic hyperplasia-pyometra complex in the bitch. In: Vet. Rec. Volume 69, 1957, pp. 1409-1415.
3. ^ Corrada et al .: The use of Cabergolin and cloprostenol to treat different stages of cystic endometrial hyperplasia-pyometra complex in the bitch. Poster IV. EVSSAR Congress Dublin, 2003

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !